Main Article Content

Ania Modarres
Omid Nabavian
Nazila Shahmansouri
Alireza Montaseri
Babak Eslami
Melika Arab Bafrani
Ebrahim Espahbodi
Shahram Samadi


Job burnout, Depression, Residency program


Introduction: In addition to the significant burden of mortality and morbidity imposed on the body of various societies, the outbreak of the Covid-19 pandemic was accompanied by a work burden on the medical staff. This high work load in health and treatment centers has been associated with adverse consequences among the medical staff, such as job burnout, psychological disorders. The major part of this burden has been imposed on medical assistants because they have been faced with a significant increase in working hours in the departments and a much higher load of care and treatment of patients with covid-19. In this study we tried to evaluate the job burnout among medical assistants during the Covid-19 era, as well as the determination of related factors.

Material and Methods: in this cross-sectional study on subjects including residency assistants at Tehran University of Medical Sciences affiliated Hospitals. The standardized Maslash questionnaire was used for job burnout, and the K10 questionnaire was used for depression screening.

Results: Regarding the component of emotional exhaustion from job burnout, mild, moderate and severe cases of this complication among the participants were 3.8%, 58.7% and 37.5%, respectively. In terms of the depersonalization component, mild, moderate and severe cases of this disorder were reported in 4.3%, 64.1% and 31.5% of the assistants, and in terms of the personal sufficiency disorder component, mild, moderate and severe cases of this disorder were reported. It was also reported in 0.5%, 12.0% and 87.5% respectively.

The occurrence of emotional exhaustion with higher intensity was expected in assistants who had experienced the previous history of taking psychoactive substances. The increase in working hours per week was also associated with the increase in the prevalence and intensity of emotional exhaustion and depersonalization components. Regarding depression, only 26.1% of people had a normal psychological state, while 14.1% had a mild disorder, 20.7% had a moderate disorder, and 39.1% had a severe disorder. This disorder was significantly more severe in women than men.

Conclusion: A significant part of our assistants suffer from burnout as well as depression during the covid-19 pandemic. Job burnout occurred mainly in men assistants, people with high weekly working hours, previous history of taking psychiatrics medication, increasing the number of years of employment in a residency course were the factors related to the occurrence of job burnout. Also, the incidence of depression was much more common among female assistants than males.


Abstract 75 | pdf Downloads 37


1- Quick JC, Tetrick LE. Handbook of occupational health psychology. Washington, DC: American Psychological Association; 2003.
2- Surawicz CM. J. Edward Berk distinguished lecture: Avoiding burnout: Finding balance between work and everything else. Am J Gastroenterol 2014; 109(4): 511-4.
3- Maslach C. Burnout, the cost of caring. Englewood Cliffs, NJ: Prentice-Hall; 1982.
4- Peckham C. Medscape lifestyle report 2017: Race and ethnicity, bias and burnout [Online]. [cited 2017 Jan 11]. Available from: URL: features/ slideshow/ lifestyl e/2017/overview
5- Prins JT, Gazendam-Donofrio SM, Tubben BJ, van der Heijden FM, van de Wiel HB, Hoekstra-Weebers JE. Burnout in medical residents: A review. Med Educ 2007; 41(8): 788-800.
6- Friedberg MW, Chen PG, Van Busum KR, Aunon F, Pham C, Caloyeras J, et al. Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Rand Health Q 2014; 3(4): 1.
7- Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA 2001; 286(23): 3007-14.
8- Sablik Z, Samborska-Sablik A, Drozdz J. Universality of physicians' burnout syndrome as a result of experiencing difficulty in relationship with patients. Arch Med Sci 2013; 9(3): 398-403.
9- European Forum of Medical, World Health Organization. Statement on the "burnout"-syndrome among physicians. Berlin, Germany: EFMA/WHO; 2003. 10. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med 2014; 89(3): 443-51.
10- Alhaffar BA, Abbas G, Alhaffar AA. The prevalence of burnout syndrome among resident physicians in Syria. J Occup Med Toxicol. 2019 Dec 10;14:31.
11- Shanafelt TD, Boone S, Tan L. Burnout and satisfaction with work-life balance among us physicians relative to the general us population. Arch Intern Med 2012; 172(18): 1377-85.
12- Maslach C, Jackson S. Maslach burnout inventory. Palo Alto, CA: Consulting Psychologists Press; 1986.
13- Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory. In: Zalaquett CP, Wood RJ, editors. Evaluating stress: A book of resources. London, UK: Scarecrow Press; 1997; p. 191-218.
14- Esfandiari GR. Survey of the rate of occupational burnout between nursing staff of Sanandaj hospitals affiliated to Kurdistan University of Medical Sciences in 2001. Sci J Kurdistan Univ Med Sci 2001; 6(1): 31-5. [In Persian].
15- Martini S, Arfken CL, Churchill A, Balon R. Burnout comparison among residents in different medical specialties. Acad Psychiatry. 2004;28(3):240-242.
16- Kalani SD, Azadfallah P, Oreyzi H, Adibi P. Interventions for Physician Burnout: A Systematic Review of Systematic Reviews. Int J Prev Med. 2018 Sep 17;9:81.
17- Msaouel P, Keramaris NC, Tasoulis A, Kolokythas D, Syrmos N, Pararas N, et al. Burnout and training satisfaction of medical residents in Greece: will the European Work Time Directive make a difference? Human Resources for Health 2010;8(1):1-11.
18- Njim T, Makebe H, Toukam L, Kika B, Fonkou S, Fondungallah J, et al. Burnout syndrome amongst medical students in Cameroon: a crosssectional analysis of the determinants in preclinical and clinical students. Psychiatry Journal 2019; 2019; 1-7.
19- Santen SA, Holt DB, Kemp JD, Hemphill RR. Burnout in medical students: examining the prevalence and associated factors. South Med J 2010;103(8):758-63. doi: 10.1097/SMJ.0b013e3181e6d6d4.
20- Almeida GdC, Souza HRd, Almeida PC, Almeida Bd, Almeida GH. The prevalence of burnout syndrome in medical students. Arch Clin Psychiatry (São Paulo) 2016;43(1): 6-10.
21- Ishak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach 2013;10(4):242-5. doi: 10.1111/tct.12014.
22- Sepehrmanesh Z, Ahmadvand A. Prevalence of burnout in the residents of Kashan and Isfahan Universities of Medical Sciences in 2012. Research in Medical Education. 2015;7(1):27-3. [In Persian]. doi: 10.18869/acadpub.rme.7.1.27
23- Montgomery A. The inevitability of physician burnout: Implications for interventions. Burnout Research 2014; 1(1): 50-6.
24- Kalani S, Azad FP, Oreyzi HR, Azizkhani R, Adibi P. Prevalence of burnout syndrome among the residents in Isfahan University of Medical Sciences, Isfahan, Iran. Journal of Isfahan Medical School 2017;35(442): 993-9. [In Persian]
25- Baer TE, Feraco AM, Sagalowsky ST, Williams D, Litman HJ, Vinci RJ. Pediatric resident burnout and attitudes toward patients. Pediatrics 2017;139(3):e20162163.
26- Bahmani A. Investigating the effect of work shifts in coronary conditions on burnout of employees with the mediating role of coronary stress. Quarterly Journal of Nursing Management (IJNV) 2021;9(4):20-6.
27- Rahmani R, Sargazi V, Shirzaei Jalali M, Babamiri M. Relationship between COVID-19-caused Anxiety and Job Burnout among Hospital Staff: A Cross-sectional Study in the Southeast of Iran. johe. 2021; 7 (4) :61-69
28- . Sadeghzade G, Rahmati S, Sadeghi F, Mohammadi Bolbanabad A, Darvishi E. Assessment of Mental Workload and Job Burnout of Medical Employees during the COVID-19 Pandemic in Iran. Iran J Ergon. 2021; 9 (2) :1-16
29- Christian Wilson R Turalde 1, Adrian I Espiritu 1 2, Ian Daniel N Macinas 3, Roland Dominic G Jamora 4 5. Burnout among neurology residents during the COVID-19 pandemic: a national cross-sectional study. Neurol Sci. 2022 Mar;43(3):1503-1511.
30- Ruchira W Khasne 1, Bhagyashree S Dhakulkar 1, Hitendra C Mahajan 2, Atul P Kulkarni 3. Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey. Indian J Crit Care Med. 2020 Aug;24(8):664-671. doi: 10.5005/jp-journals-10071-23518.
31- Dante Duarte 1, Mirret M El-Hagrassy 2, Tiago Couto 3, Wagner Gurgel 4, Benicio N Frey 1 5, Flavio Kapczinski 1 6, Humberto Corrêa 7. Physician suicide demographics and the COVID-19 pandemic. Braz J Psychiatry. Mar-Abr 2022;44(2):124-135. doi: 10.1590/1516-4446-2021-1865.
32- Samer Al-Humadi 1, Brian Bronson 1, Samantha Muhlrad 1, Megan Paulus 1, Houlin Hong 1, Ricardo Cáceda 2 3. Depression, Suicidal Thoughts, and Burnout Among Physicians During the COVID-19 Pandemic: a Survey-Based Cross-Sectional Study. Acad Psychiatry. 2021 Oct;45(5):557-565.
33- Samadi S, Hussain Khan Z, Mireskandari SM, Karvandian K, Jafarzadeh A, Hajipour A. Preserving Resilience for Prevention of Burnout in Anesthesiology Residents as Frontline Healthcare Workers During the COVID-19 Outbreak: A Report of Real-life Experiences of Professionalism and Mentoring in Medical Education. J Family Reprod Health. 2022;16(4):296-299.
34- Alipour, F., Asghari, F., Samadi, S., Amini, H., Shahvari, Z. Evaluation System problems & maintaining professional behavior; The perspective of healthcare providers in Iran. International Journal of Hospital Research, 2017; 6(1): 1-7.
35- Alipour F, Shahvari Z, Asghari F, Samadi S, Amini H. Educational system defects and observing professional behavior: A qualitative study. J Educ Health Promot. 2019;8:162. Published 2019 Aug 30.
36- Etesam F, Arab Bafrani M, Akbarpour S, Tarighatnia H, Rajabi G, Dolatshahi M, Vahabi Z. Depression, Anxiety and Coping Responses among Iranian Healthcare Professionals during the Coronavirus Disease (COVID-19) Outbreak. Iran J Psychiatry. 2022 Oct;17(4):446-454.